A case of ascending colon volvulus in very elderly patient

Abstract

A 99-year-old man visited his doctor for abdominal pain and vomiting. He was diagnosed with an intestinal obstruction and referred to our hospital. A CT scan revealed a whirl sign located on right side of the stomach and an extended intestine on the left side of the stomach. It was difficult to identify the twisted portion. He was diagnosed with strangulation ileus, which required emergency surgery. It was revealed that the strangulated portion of the intestine was the terminal ileum to the ascending colon which was poorly fixed to the retroperitoneum. He underwent a right hemicolectomy. He was discharged 19 days post-operation. Ascending colon volvulus is rare and difficult to diagnose. However, a quick decision is required, because it can cause intestinal necrosis and perforation.